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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700524
Report Date: 08/19/2021
Date Signed: 08/19/2021 02:37:30 PM

Document Has Been Signed on 08/19/2021 02:37 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:VRETCHEN MARIE CAREFACILITY NUMBER:
342700524
ADMINISTRATOR:GARCIA, VRETCHEN MARIE JFACILITY TYPE:
740
ADDRESS:7232 CIRCLET WAYTELEPHONE:
(916) 242-8999
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY: 6CENSUS: 0DATE:
08/19/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Vretchen Marie J Garcia, AdministratorTIME COMPLETED:
02:45 PM
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Licensing Program Analysts (LPAs) Angela Hood and Michael Hood arrived at the facility unannounced on 8/19/2021 to conduct a Required-1 Year Inspection utilizing the infection control domain, LPAs met with Vretchen Marie Garcia, Administrator, and explained the purpose of the visit. Prior to initiating the annual inspection, LPAs completed required COVID-19 testing protocols, the daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms, and contacted facility and completed a facility risk assessment. LPAs ensured to apply hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Masks.

The facility currently has no residents.

LPAs toured the facility. Areas toured include but are not limited to: 5 bedrooms and 3 bathrooms for residents, common area, dining room, kitchen, outdoor area, and viewed PPE supplies. In the areas toured no immediate health, safety, or personal rights violations were observed. LPAs and Administrator completed the infection control domain and facility was found to be in substantial compliance at this time.

No deficiencies are being cited. Exit interview conducted and copy of report left at the facility.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE: DATE: 08/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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